menopause question for dr.

[mariaitaly]

hi,
can someone give me some advice!
it has been 2-3 mths now that i know i have menopause.
but now it has been 8 days where every night, i get up and
have to watch a movie to go back to sleep because of the
hot sweats i have.

i just phoned my gineocologist and i asked if the iud
that i once use to have (i have forgotton the name, but it
had hormones in it and my periods stopped)
if that could help me.   i have read hormones help but of
course can give cancer.  but then i thought that if the
hormones are local it could be different?
can anyone answer me for sure or deny my opinion on this?
thanks maria

[Jillie1]

I agree with the doctor primarily but on the risk factor you never know especially if non of your family have a history of blood clots.  I  discovered too late  (5 years) that I had one gene in the V-Leiden factor which predisposes you to blood clotting. Unless you have that specific test you would probably never know. I was on 0.625 mg Premarin, admittedly for nearly 10 years, but the risk to me was worth the blood clot I developed.  I was hot flash free - it is almost like a miracle.  I now take an anti-coagulent pill every day.

[Machelle Seibel, MD]

Using an IUD with hormones usually can not be expected to help symptoms like hot flashes - the dosages are too low and they do not get into very high levels in the blood stream. Hormones such as estrogen and progesterone can help most of the time with your symptoms.

Hormones do have a small risk of blood clots, heart attack and breast cancer. According to the largest study on this subject (The Women's Health Initiative), the risk for each is increased by about 8 in 10,000 over women who did not take estrogen and progesterone (the medication was Prempro). That is 0.8 per 1,000 and 0.08 per 100 which is less than 1/10th of 1 percent. So it is real, but it is small. If you have a risk of blood clots and a risk of breast cancer, this risk is more worrisome than if you don't.

You can take hormones orally like the one in the study above or take them through the skin. Blood levels are the same. You can also take them through the vagina and depending on the brand, the amount in the blood might be lower.

If your symptoms are bad and you are not at a very high risk for cancer or blood clots, it might make sense to try a short course of hormones. Try the lowest dosage first and see if it is enough. Often a little hormones helps a lot. Be sure and talk about it with your doctor and see if it is for you.
Machelle Seibel, MD